Parents may be getting the wrong message from mainstream magazines about safe sleeping for their infants, researchers found.

Action Points

Explain to interested patients that this study found many photographs of sleeping babies in magazines aimed at women or parents that depicted unsafe sleep practices. This may be a good time to explain safe sleeping practices.

Explain that this study, though it identified photos showing unsafe infant sleeping practices in magazines, could not determine the effect of those photos on the parenting practices of adults.

Parents may be getting the wrong message about safe sleeping for their infants from mainstream magazines, researchers found.

More than one-third of photographs in advertisements and articles in magazines geared toward women, expectant parents, and parents of young children showed babies sleeping on their sides or stomachs, according to Rachel Moon, MD, of Children's National Medical Center in Washington, and colleagues.

Moreover, nearly two-thirds of the photographs depicted infant sleep environments that were unsafe, they reported online in Pediatrics.

The discrepancy between what parents see on a daily basis and what they hear from healthcare professionals could create confusion and the potential for unsafe practices, the researchers said.

"The most important thing for moms to realize is that what they see in magazines may not be what's best for their baby in real life," Moon said.

The American Academy of Pediatrics started recommending that babies sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS) in 1992. It has since advised parents to remove pillows, soft bedding, and other objects from infant sleep areas.

Rates of SIDS dropped following these recommendations, but SIDS remains the most common cause of infant death, according to the researchers.

Studies have shown that messages parents receive through the media were more likely to result in compliance with the AAP's recommendations than those delivered by healthcare professionals. So Moon and her colleagues wanted to see how media portrayals of sleeping infants compared with the guidance.

They analyzed 28 magazines that had wide circulation among women 20 to 40 years old, or were targeted to expectant parents or parents with young children. The researchers looked for pictures in advertisements or articles depicting sleeping infants or infant sleep environments.

Of 122 unique pictures of infants sleeping, only 64% showed the babies sleeping on their backs. Compared with news articles, advertisements were more likely to show babies sleeping on their sides or stomachs (39% versus 27%).

Of 99 photographs of sleep environments without an infant present, only 36.4% were deemed safe according to AAP recommendations. The rest of the photographs included blankets, pillows, wedges, stuffed animals, and soft surfaces.

Pictures from advertisements and articles were equally likely to show unsafe sleep environments.

Soft and loose bedding increases the risk of SIDS about five-fold overall and 21-fold when babies are also sleeping on their stomachs, according to the researchers.

Among the pictures of cribs, 85.2% had bumper pads. Although these were not classified as unsafe for the purposes of the study, both firm and soft bumper pads confer some risk to the infant.

Parents use these because they believe they will prevent injury to their infant, the researchers said, although there is little evidence that babies can injure themselves against the crib sides.

The authors said the study was inherently limited because it only analyzed magazines with pictures of sleeping infants.

In addition, they said, there were no pictures identified in magazines aimed specifically at a black audience, so they could not explore the possible influence of media on the observed racial disparity in SIDS.

Finally, they were unable to evaluate the effect of these pictures on parents' decisions regarding sleep arrangements.

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